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Research Letter
June 5, 2018

Use of Conservative Management for Low-Risk Prostate Cancer in the Veterans Affairs Integrated Health Care System From 2005-2015

Author Affiliations
  • 1Manhattan Veterans Affairs Medical Center, New York, New York
  • 2Department of Urology, New York University, New York
  • 3Department of Population Health, New York University, New York
JAMA. 2018;319(21):2231-2233. doi:10.1001/jama.2018.5616

Low-risk prostate cancer has a favorable prognosis without treatment. Current guidelines recommend conservative management or deferring upfront treatment as the preferred approach,1 but previous studies reported underutilization in the United States2,3 compared with other countries.4 Qualitative data suggest that financial incentives and medicolegal concerns are barriers to uptake by US physicians.5 We examined utilization of conservative management in the US Department of Veterans Affairs (VA), an integrated health care system providing equal access for patients without financial incentives for physicians to provide high-volume care.